1. JAUNDICE JAUNDICE By:DR/FATMA AL-THOUBAITY Surgical Consultant Assisstant Professor

2. Jaundice the yellowish discoloration of skin, sclerae, and mucous membranes that results from excessive deposition of bilirubin in tissues. the yellowish discoloration of skin, sclerae, and mucous membranes that results from excessive deposition of bilirubin in tissues.

3. The normal level of bilirubin in blood serum is between 0.2 mg/dL and 1.2 mg/dL The normal level of bilirubin in blood serum is between 0.2 mg/dL and 1.2 mg/dL

4. The liver normally produces about 1 liter of bile each day. The liver normally produces about 1 liter of bile each day.liver

5. Usually the concentration of bilirubin in the blood must exceed 2–3 mg/dL for the coloration to be easily visible Usually the concentration of bilirubin in the blood must exceed 2–3 mg/dL for the coloration to be easily visiblebloodmgdLbloodmgdL

6. 42 mmol/L (2 mg/dl) 42 mmol/L (2 mg/dl)

7. Bilirubin is a yellowish pigment that is produced from the breakdown of heme, mostly from hemoglobin and red blood cells (RBCs). It is transported by the blood to the liver, where it is excreted in bile, eventually reaching the small intestine. Bilirubin is a yellowish pigment that is produced from the breakdown of heme, mostly from hemoglobin and red blood cells (RBCs). It is transported by the blood to the liver, where it is excreted in bile, eventually reaching the small intestine.

8. Cause of Jaundice

11. Causes in children include: newborn jaundice (physiologic jaundice) breastfeeding jaundice breast milk jaundice viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E) hemolytic anemia disorders present since birth that cause problems processing bilirubin (Gilbert's syndrome, Dubin-Johnson syndrome, Rotor's syndrome, or Crigler-Najjar syndromes) biliary atresia autoimmune hepatitis malaria Breastfeeding jaundice may occur in the first week of life in more than 1 in 10 breastfed infants. The cause is thought to be inadequate milk intake, leading to dehydration or low caloric intake. It is a type of physiologic or exaggerated physiologic jaundice. newborn jaundice (physiologic jaundice) breastfeeding jaundice breast milk jaundice viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E) hemolytic anemia disorders present since birth that cause problems processing bilirubin (Gilbert's syndrome, Dubin-Johnson syndrome, Rotor's syndrome, or Crigler-Najjar syndromes) biliary atresia autoimmune hepatitis malaria Breastfeeding jaundice may occur in the first week of life in more than 1 in 10 breastfed infants. The cause is thought to be inadequate milk intake, leading to dehydration or low caloric intake. It is a type of physiologic or exaggerated physiologic jaundice.

12. Causes in adults include: blocked bile ducts (by infection, tumor or gallstones) viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E) drug-induced cholestasis (bile pools in the gallbladder because of the effects of drugs) drug-induced hepatitis (hepatitis triggered by erythromycin sulfa drugs, antidepressants, anti-cancer drugs, Aldomet, rifampin, steroids, chlorpropamide, tolbutamide, oral contraceptives, testosterone, propylthiouracil) biliary stricture alcoholic liver disease (alcoholic cirrhosis) cancer of the pancreas primary biliary cirrhosis ischemic hepatocellular jaundice (jaundice caused by inadequate oxygen or inadequate blood flow to the liver) intrahepatic cholestasis of pregnancy (bile pools in the gallbladder because of the pressure in the abdomen with pregnancy) hemolytic anemia disorders present since birth that cause problems processing bilirubin (Gilbert's syndrome, Dubin-Johnson syndrome, Rotor's syndrome, or Crigler-Najjar syndromes) chronic active hepatitis autoimmune hepatitis malaria blocked bile ducts (by infection, tumor or gallstones) viral hepatitis (hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E) drug-induced cholestasis (bile pools in the gallbladder because of the effects of drugs) drug-induced hepatitis (hepatitis triggered by erythromycin sulfa drugs, antidepressants, anti-cancer drugs, Aldomet, rifampin, steroids, chlorpropamide, tolbutamide, oral contraceptives, testosterone, propylthiouracil) biliary stricture alcoholic liver disease (alcoholic cirrhosis) cancer of the pancreas primary biliary cirrhosis ischemic hepatocellular jaundice (jaundice caused by inadequate oxygen or inadequate blood flow to the liver) intrahepatic cholestasis of pregnancy (bile pools in the gallbladder because of the pressure in the abdomen with pregnancy) hemolytic anemia disorders present since birth that cause problems processing bilirubin (Gilbert's syndrome, Dubin-Johnson syndrome, Rotor's syndrome, or Crigler-Najjar syndromes) chronic active hepatitis autoimmune hepatitis malaria